Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea.

Abstract

BACKGROUND:

Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known.

OBJECTIVE:

To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve.

METHODS:

Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up.

RESULTS:

Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean +/- SD episodes per hour, 52.0 +/- 20.4 for baseline nights and 22.6 +/- 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2 +/- 30.5 and 16.6 +/- 17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment.

CONCLUSION:

The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.

• Authors: A R Schwartz, M L Bennett, P L Smith, W De Backer, J Hedner, A Boudewyns, P Van de Heyning, H Ejnell, W Hochban, L Knaack, T Podszus, T Penzel, J H Peter, G S Goding, D J Erickson, R Testerman, F Ottenhoff, D W Eisele
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 127 Issue 10 Pg. 1216-23 (Oct 2001) ISSN: 0886-4470 [Print] United States
• PMID: 11587602 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Oxyhemoglobins

Topics

• Adult
• Electric Stimulation Therapy (instrumentation, methods)
• Follow-Up Studies
• Humans
• Hypoglossal Nerve (physiology)
• Male
• Middle Aged
• Oxyhemoglobins (analysis)
• Sleep Apnea, Obstructive (therapy)
• Sleep, REM